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Using a cost-benefit framework for financial planning services and proprietary data collected in the summer of 2008, the client characteristics that are associated with the likelihood of paying for professional financial advice, as well as the type of financial services purchased, are identified. Results indicate that respondents who pay for financial advice are more likely to be female, relatively older, wealthier, and college educated but do not have a high level of self-reported knowledge about financial issues. Of the respondents who purchase financial advice, those who are comprehensively-managed are more likely to be under 65, wealthy, and have high self-reported knowledge about financial issues. This study reveals important differences between the decision to pay for financial advice and the type of financial services purchased. (Contains 2 tables and 1 endnote.)

Clients' self concepts and dissociative experiences were examined to determine the impact of an Adlerian based pretrial diversion program. Clients completing the program displayed a significant change in self concepts and dissociative experiences. A repeated measures multivariate analysis of variance indicated a 35% change, made up of the self-concept subscales: Physical, Moral, Social, Academic/Work, and Personal and an overall dissociation score. (Contains 3 tables and 1 figure.)

A cross-sectional survey was conducted across two samples of counselling clients to estimate the prevalence of two sets of counselling alliance type preferences: (a) nurturant, insight-oriented, or collaborative alliance; and (b) personal or professional alliance. Results indicated that participants generally preferred an insight-oriented alliance type over a nurturant one and, in one sample, a collaborative type over a nurturant one. In addition, participants in both samples preferred a personal or professional alliance about equally. These findings support the existence of tangible alliance type preferences across clients.

Data from the National Education Longitudinal Study of 1988-2000 (NELS: 88) were used to examine the characteristics of students who see their school counselor about general, academic, career, and academic issues. Study results indicated that overall, school counselors were more likely to have contact with students who are identified as at-risk for school failure. Implications for future school counseling research are discussed. (Contains 4 tables.)

Constrained public funding for universities and the emphasis placed on university-industry interactions mean that universities are increasingly required to compete for industrial funds for research. This in turn means that universities need to develop a customer service culture in order to be competitive and attractive to industry. Many studies examine industry-university relationships, their importance and ways to improve interactions but publications examining customer service quality in the context of the provision of university research services or technology transfer services to industry are lacking. This article recommends a modified SERVQUAL (service quality survey instrument) approach and the survey results identify several opportunities for improved service delivery practice. (Contains 1 table and 4 figures.)

Canadian counsellors are increasingly called upon to work with diverse client populations whose needs may not be met through traditional counselling models. The question for many is how to develop the attitudes, knowledge, and skills for competent and ethical practice. This article introduces core competencies designed to assist counsellors to effectively infuse culture into all aspects of the counselling process. It then describes how these competencies are combined to enhance the multicultural competence of counsellors. Practical strategies are then introduced to provide a starting place for counsellors who identify the need for further professional development to increase their multicultural competence.

This study examined the outcome of extended counselling sessions at a community counselling centre. Participants were 38 female and 7 male clients who were categorized as dealing with one of the following issues: trauma, multiple acute issues, complicated grief, or support while waiting for referral. Results showed a significant lessening of symptoms and increase in coping skills between sessions 12 and 24 for all clients. Having previous counselling was significantly related to magnitude of change on the Target Complaint change score. Through qualitative analyses, trauma and nontrauma clients described similar types of change from counselling: gaining insight, experiencing feelings, counselling relationship, self-growth, and new ways of being. However, some differences were apparent in the way that these categories were discussed by the trauma and nontrauma clients.

This paper briefly reviews existing conceptualizations of resistance in counseling children. The author posits that resistance is an "expected" aspect of all counseling and offers an alternative orientation toward client resistance based on exploring the child's "helping narratives." Two case studies illustrate the implementation of this intervention and its integration within the rapport-building process of counseling with children.

The TESOL (teaching of English to speakers of other languages) sector in New Zealand is rapidly developing into a major educational service industry. Despite their growing national importance, little is known about the performance of the English language centres (ELCs) that constitute the industry. This study investigated levels of client satisfaction with New Zealand ELC service at a national level. The research took a services management approach, using a multilingual questionnaire covering nine dimensions of ELC service. The findings indicated that, overall, clients registered mere satisfaction with the service provided. Statistical analysis identified significant differences between levels of client satisfaction in terms of client age and nationality and between ELCs of different type and size. While service provider personal attributes were positively rated by respondents, these did not play a major role as predictors of client satisfaction or the willingness to recommend an ELC. (Contains 13 tables and 2 figures.)

Canadian studies examining suicide among rural and farm populations remain scarce. To better understand this phenomenon, a qualitative research paradigm was used to analyze encounter forms of 29 individuals (24 men, 5 women) who called the Manitoban Farm and Rural Stress Line. Content analysis revealed 7 major themes: (a) coping mechanisms, (b) financial concerns, (c) health issues, (d) family salvation, (e) uncontrollable events, (f) family stress, and (g) farm culture. Consistent with previous research, it was noted that farmers appear to experience various stressful events, with finances being a key concern. Additionally, farmers report common characteristics not conducive to help-seeking behaviour. This research indicates a need for increased services specific to Manitoban farmers.

Despite evidence that First Nations people experience a disproportionate degree of mental health concerns relative to other Canadians, many within this population do not access Western-based mental health services. In this article we extend a socio-political and historical rationale for attending to key cultural differences when working with First Nations clientele. These cultural differences are situated within the three commonly held domains of multicultural competence: self-awareness, knowledge of the other, and therapeutic practice.

Objective: The purpose of this study was to assess the need for incorporating perceived importance of service elements into client satisfaction measures. Method: A secondary analysis of client satisfaction data from 112 clients of an elderly case management setting was conducted. Results: This study found that the relationship between global client satisfaction and the composite of satisfaction with service elements differed significantly, depending on perceived importance of service elements. Conclusions: These results call into question the practice of simply adding or averaging scores from satisfaction items to produce global satisfaction scores without considering perceived importance of the service elements. (Contains 2 tables.)

This study documents significant differences in alliance in a predominantly Latino sample of adolescents who either completed or dropped out of a Guided Self-Change treatment program. Therapeutic alliance, working alliance, and patient involvement were assessed via ratings of audio-recorded segments of participants' counseling sessions. Descriptive discriminant function analysis identified working alliance goals, patient participation, and therapist warmth and friendliness variables as significantly predictive of completion status. These results were confirmed via follow-up logistic regression analyses. The use of brief clinical tools to monitor and manage alliance among adolescents receiving treatment who are at risk for dropout is discussed. (Contains 5 tables.)

This study explored the prevalence of violent behaviors in patients who are addicted to drugs. A sample of 252 addicted patients (203 male and 49 female) who sought outpatient treatment was assessed. Information on violent behaviors, sociodemographic factors, consumption factors (assessed by the European version of the Addiction Severity Index [EuropASI]), psychopathology's factors (assessed by Symptom Checklist-90-Revised [CL-90-R]), and personality variables (assessed by Millon Clinical Multiaxial Inventory [MCMI-II]) was collected. Drug-addicted patients who were associated with violent behaviors were compared on all variables with patients who were not associated with violent behaviors. The rate of drug-addicted patients with violent behaviors in this sample was 39.68% (n = 100). There were significant differences between the numbers of patients who did and did not demonstrate violence on some variables. Patients with violence problems were younger than those without violence problems and were more likely to report having been a victim of abuse. Moreover, they were significantly more likely to have experienced an overdose and showed a significantly higher score on several EuropASI, SCL-90-R and MCMI-II variables. According to these results, patients with violence control problems present with both a more severe addiction and several comorbid problems. The implications of these results for further research and clinical practice are discussed. (Contains 4 tables.)

Child sexual abuse (CSA) often requires psychological treatment to address the symptoms of victim trauma. Barriers to entry and completion of counseling services can compromise long-term well-being. An integrated medical and mental health evaluation and treatment model of a child advocacy center (CAC) has the potential to reduce barriers to mental health treatment. Objective: (a) to describe characteristics between CSA patients who engage versus those who do not engage in mental health treatment and (b) to identify factors associated with successful completion of mental health treatment goals. For design/setting, a retrospective cohort study was conducted of CSA patients (ages 3-16 years) referred to mental health services following a CAC assessment. Outcome variables included linkage with treatment and completion of treatment. Independent variables included demographics, abuse characteristics, and therapist characteristics. Data were abstracted from the CAC and billing databases. Results: Four hundred ninety subjects were evaluated. Subjects were as follows: predominately female (74%), White (60%), and more than half received Medicaid (56%). Mean age was 8.4 years. About 52% linked with mental health services and 39% of patients that successfully linked with mental health services completed therapy. Successful linkage was independently associated with referrals to other counseling services (AOR 8.4 [2.5, 27.7]). Successful completion of therapy was independently associated with caregiver participation in therapy (AOR 3.2 [1.8, 6.0]) and if the patient was referred to other counseling services (AOR 4.1 [1.9, 8.5]). There were no differences between subjects that linked and/or completed therapy and those that did not with regard to demographic characteristics or abuse severity. Conclusion: In contrast to previous reports, efforts at our CAC seem to overcome linkage barriers in this population. However, there remain challenges in achieving successful completion of treatment goals in this population. Engaging caregivers' involvement in therapy services had a positive effect with successfully achieving treatment goals. (Contains 4 tables and 1 figure.)

We investigated the associations of surgeons' emotional intelligence and surgeons' empathy with patient-surgeon relationships, patient perceptions of their health, and patient satisfaction before and after surgical procedures. We used multi-source approaches to survey 50 surgeons and their 549 outpatients during initial and follow-up visits. Surgeons' emotional intelligence had a positive effect (r = 0.45; p less than 0.001) on patient-rated patient-surgeon relationships. Patient-surgeon relationships had a positive impact on patient satisfaction before surgery (r = 0.95; p less than 0.001). Surgeon empathy did not have an effect on patient-surgeon relationships or patient satisfaction prior to surgery. But after surgery, surgeon empathy appeared to have a significantly positive and indirect effect on patient satisfaction through the mediating effect of patients' self-reported health status (r = 0.21; p less than 0.001). Our study showed that long-term patient satisfaction with their surgeons is affected less by emotional intelligence than by empathy. Furthermore, empathy indirectly affects patient satisfaction through its positive effect on health outcomes, which have a direct effect on patients' satisfaction with their surgeons. (Contains 3 tables and 1 figure.)

Aim: To effectively provide clinical placements for students and increase healthcare options for rural communities, an investigation of university clinics was conducted. Method: This project adopted a consultative inquiry strategy and involved two processes: (1) a review of literature; and (2) interviews with existing health sciences clinic staff. Results: Low income population groups are more likely to find student-provided services acceptable and have a reliable demand for these services if they are accessible. University clinics reporting high client numbers had a consistent flow of low income clients with chronic problems. Private healthcare providers were often unable to meet the demand from this group. However, multiple methods and flexibility of delivery that fitted in with local services were required rather than single point of access clinics. Discussion: University clinics are an effective way of providing clinical placements for students and some healthcare for rural communities. Key aspects of the community context that make a university clinic viable are the degree of disadvantage in a community, the population density (or dispersion), the workforce available to supply health services in the public and private sectors, and the types of services that are demanded by policy or lobby groups and not yet supplied. (Contains 1 table.)

This study aims to examine the relationship between spirituality and believing in God's presence and depressive symptoms among 160 inpatient individuals who abuse substances. Findings indicated that both spirituality and believing in God's presence were significant predictors of depressive symptoms, whereby spirituality was inversely related to depressive symptoms and believing in God's presence was positively related to depressive symptoms. These findings may have implications for mental health practitioners considering implementation of spiritually based interventions that can develop and strengthen clients' spirituality. (Contains 1 table.)

Treating suicidal clients with borderline traits can be conducive to burnout. Dialectical behavior therapy (DBT) may assuage this burnout in counselors. As part of a DBT treatment outcome study, 6 counselors in training collected their own salivary cortisol samples and completed self-report measures of burnout and well-being for 1 year. Findings indicate a significant interaction for cortisol levels by treatment condition, such that DBT counselors experienced less physiological stress over time relative to a control group of counselors. There were no group differences in self-reported burnout or well-being. DBT may have a salutary effect on trainees' physiological stress levels over time.

Most clients attend only a few sessions before dropping out of counseling and, consequently, never traverse the series of stages delineated in many counseling process models. There is frequently a mismatch between the counseling process as portrayed in many counseling textbooks with the counseling process students are likely to experience when they begin practicum and internship placements. Based on the counseling duration and premature termination literature, this article considers several models that counselor educators could adopt to better prepare students to work with the large proportion of clients who will often attend only a few sessions before terminating contact.

This study sought to identify client, professional, and employment characteristics that enhance licensed social workers' commitment to aging practice. A series of binary logistic regressions were performed using data from 181 licensed, full-time social workers who reported aging as their primary specialty area as part of the 2004 NASW's national study of licensed social workers. Several variables were identified as being significant predictors of commitment to aging, including clients' source of insurance, practitioners' years of experience in social work and gerontology, perceived adequacy of training, number of social work colleagues in the work environment, perceived appropriateness of delegated tasks, and annual income. This study illuminates critical areas of need to promote professional commitment to aging practice. Promotion of training and competency-based education and the need for sufficient job challenge and appropriate assignment of roles (that is, those that are consistent with practitioners' skills and abilities) will encourage commitment to working in the field of gerontology.

Objective: Despite substantial progress in the development and identification of psychosocial evidence-based treatments (EBTs) in mental health, there is minimal empirical guidance for selecting an optimal "set" of EBTs maximally applicable and generalizable to a chosen service sample. Relevance mapping is a proposed methodology that addresses this problem through structured comparison of client characteristics in a service sample to participant characteristics from studies of EBTs. Method: The authors demonstrate the feasibility of relevance mapping using data from 1,781 youths in a statewide mental health system and a study data set including 437 randomized clinical trials. Relevance mapping (a) reveals who is "coverable" by any EBT, under different definitions of matches between study participants and clients, and (b) identifies minimum sets of treatments needed to serve maximum numbers of clients, across different levels of analysis for defining treatment operations. Results: In the illustration sample, all problems targeted by the study data set review were fully coverable when matching only required clients to have the same problem as EBT study participants. At the other extreme, when matching also required age, gender, ethnicity, and setting, the percentage of noncoverable youths increased to 86% in this sample. Two minimal sets of only 8 EBTs were identified that, when added to the one EBT already in place in that system, covered 100% of coverable youths when matching required problem, age, and gender. Conclusions: This methodology offers promise for the empirically guided selection and coordination of EBTs, thereby addressing one aspect of the gap between knowledge and practice. (Contains 2 figures, 2 tables and 1 footnote.)

This article is third in a series of exemplary cases under the two current section editors. The first two cases (Brandon, Smith, Trenholm, & Devaney, 2010; Smith, Brandon, Lawton, & Krohn-Ching, 2010) profiled evaluations that had been designated as exemplary by professional associations. The present case profiles an evaluation organization: Social Program Evaluators and Consultants, Inc., which goes by the name of SPEC Associates. This Exemplars case reflects the authors' intent, stated in their editorial statement, "to broaden the nature of evaluation practice to be examined in this section to include not only discrete studies but also such forms of evaluation practice as long-term consulting arrangements" (Brandon & Smith, 2010, p. 252). Their focus is on the lessons learned by SPEC's seasoned Chief Executive Officer (CEO), Dr Melanie Hwalek, about the key aspects of evaluation work that account for successful evaluation practice at a private firm. They use three evaluations identified by Dr. Hwalek as illustrative of SPEC's evaluation practices to highlight these aspects of SPEC's work. These evaluations are intended to help enlighten readers about aspects of SPEC and its evaluation practice, as well as the contextual characteristics that typically contribute to or hinder the design and conduct of SPEC's evaluations.

Dyslexia does not cause criminal behaviour, but it may worsen aggressive behaviour tendencies. In this study, aggressive behaviour and risk of future violence were compared between forensic psychiatric patients with and without dyslexia. Dyslexia was assessed using the Swedish phonological processing battery "The Pigeon". The patients filled in the Aggression Questionnaire, and trained assessors performed the risk assessments using HCR-20 version 2. Patients with dyslexia self-reported more aggressive behaviour compared with those without dyslexia. There was only a nearly significant tendency (p = 0.06) for the patients with dyslexia to receive higher scores in the HCR-20 compared with the patients without dyslexia, and phonological processing skills did not significantly predict aggression or risk of future violence. However, regression analyses demonstrated that poor phonological processing skills are a significant predictor of anger, which in turn significantly predicts risk of future violence. (Contains 1 table.)

An existing database was used to compare problem gamblers (N = 138) who presented for treatment of their gambling problem to two other groups: alcohol and/or drug addiction clients who also had a gambling problem (N = 280) or who did not have a gambling problem (N = 2178). Clients with gambling as their primary problem were more likely to be female; employed or retired; more highly educated; married, divorced, or widowed; without legal problems; and older than the other groups. They also had different patterns of recent mental health diagnoses and problematic substance use. The other problem gambling clients were more similar to the substance only clients. These findings indicate that those who present for treatment of problem gambling are a distinct subset of addiction clients who have gambling problems, and emphasize the importance of considering the reasons for seeking treatment, not just the presence of a gambling problem.

Ryan and colleagues are applauded for elevating client factors in the form of motivation and autonomy to equal status with the alliance as common factors in psychotherapy. Next, client motivation and autonomy are explained to be inextricably linked with one promoting the other. Motivational methods are summarized for the major approaches, making the point that some motivational approaches are more related to the promotion of client autonomy. Change talk is explained as similar to solution talk. Both are social constructivist methods of motivating clients and overcoming impasse in therapy. Matching client beliefs, using client strengths, and providing compelling rationales are underscored as motivational techniques. Similarities between motivation and hope are drawn through Snyder's hope theory and Frank and Frank's contextual model of psychotherapy. Finally, motivation and the formation of the alliance are discussed as factors that overlap conceptually and interact as variables in research.

Background: This study compares outpatients with intellectual disability (ID) receiving specialised services to outpatients with ID receiving general services in Ontario's tertiary mental healthcare system in terms of demographics, symptom profile, strengths and resources, and clinical service needs. Methods: A secondary analysis of Colorado Client Assessment Record data collected from all tertiary psychiatric hospitals in the province was completed for a stratified random sample of 246 outpatients identified as having ID, from both specialised and general programmes. Results: Individuals with ID in specialised programmes differed from patients with ID in general programmes with regard to demographics, diagnostic profile, symptom presentation and recommended level of care. Conclusions: Further research is required to determine why individuals access some services over others and to evaluate whether specialised services are more appropriate for certain subgroups with ID than others.

In this article, the authors identify the cultural and spiritual assessments needed to conduct counseling with Muslim Americans and Muslim immigrants to the United States. Assessment processes are outlined that include cultural identity (which subsumes several variables); worldview; spiritual assessment along with acculturation level and migration concerns; impact of languages spoken; social, occupational, and educational status of the client in host culture and in home culture (if the client is an immigrant); and family composition and social supports.

This research describes and analyses recent policy developments in Ireland in relation to the practice of selling psychoactive substances which, while not themselves illegal, mimic the effects of commonly used illegal drugs. These so-called "legal highs" had been sold in Ireland through an increasing number of "head shops" which in late-2009 and early-2010 became the subject of considerable public controversy, culminating in legislative measures aimed at their closure. Based on semi-structured interviews with some of the main stakeholders in this process and set against a background of saturation media coverage of this phenomenon, this article presents and assesses competing perspectives on the head shop issue. From a conventional drug control perspective, recent legislative measures in Ireland may be seen as representing effective cross-cutting activity between the health and criminal justice sectors. From a harm reduction perspective, however, this policy response may be seen as an example of moral panic in that media portrayals greatly exaggerated the ill effects of head shop products, in the process stoking public anger rather than encouraging rational debate.

Asian Americans drop out of mental health treatment at a high rate. This problem could be addressed by enhancing therapists' multicultural competence and by examining clients' cultural attitudes that may affect the counseling process. In the present study, we used a video analogue design with a sample of 113 Asian American college students to examine these possibilities. The result from a "t" test showed that the session containing therapist multicultural competencies received higher ratings than the session without therapist multicultural competence. In addition, correlational analyses showed that participant values acculturation was positively associated with participant ratings of counseling process, while the value of emotional self-control was negatively correlated. The results of a hierarchical multiple regression analysis did not support any interaction effects among the independent variables on counseling process. All of these findings could contribute to the field of multicultural competence research and have implications for therapist practices and training. (Contains 2 tables.)

Vocational overshadowing has been defined as an underemphasis on career concerns when personal problems coexist. This study explored whether vocational overshadowing occurred based on observers' perception of the setting (i.e., either career counseling center or mental health counseling center). Clinicians in-training viewed an analogue counseling session in which the only difference between the two vignettes was whether the session was conducted in a career counseling center versus a mental health counseling agency. The participants then completed measures of the working alliance, evaluation of session process, and level of client's neuroticism. Clinicians in-training perceived the working alliance, session factors (i.e., depth, smoothness, and arousal), and client's level of neuroticism similarly, regardless of the setting of the session. The only slight difference was in the participants' perceptions of the session conducted in a career center. Implications of these findings for research, practice, and education were discussed. (Contains 1 table.)

This article presents the results of a study into the provision of Internet training for adult public library clients. The study, which was completed in 2008, forms part of a larger investigation into the characteristics, preferences and needs of adult public library clients in New South Wales. The aim of this section of the investigation is to gain an understanding of client needs and preferences when being trained in the use of online resources in order to assist public library staff in providing relevant guidance and instruction to the community. The research takes the form of a multiple exploratory case study based on naturalistic inquiry, using grounded theory as an operational characteristic. Twenty-four public library clients were interviewed to gain an understanding of client needs in an online environment. The study identifies two main approaches to face-to-face training on Internet resources, client preferences for informal and formal tuition depending on their level of expertise. With the study indicating that computers inspire mixed feelings for the less experienced user, it is important to establish training courses tailored to specific needs to ensure the development of confidence in the use of online resources. (Contains 2 tables and 1 figure.)

When, why, and how clinicians decide to write about clients are ethical concerns. There are risks and potential clinical ramifications as well as responsibilities for how these decisions are made. On the basis of 141 interviews with psychoanalysts who have published in 3 major national and international psychoanalytic journals, the author explores decisions about whether to only disguise the client's material or whether, in addition, to ask consent outlines and some of the clinical consequences. The author concludes that clinicians need to individualize their decision making based on the particular client and the nature of the therapeutic relationship and offers ways to go about making these judgments.

The phenomenon of spiritual bypass has received limited attention in the transpersonal psychology and counseling literature and has not been subjected to empirical inquiry. This study examines the phenomenon of spiritual bypass by considering how spirituality, mindfulness, alexithymia (emotional restrictiveness), and narcissism work together to influence depression and anxiety among college students. Results suggested that mindfulness and alexithymia accounted for variance in depression beyond what is accounted for by spirituality and that all 3 factors (mindfulness, alexithymia, and narcissism) accounted for variance in anxiety beyond what is accounted for by spirituality. Implications for counselors are provided. (Contains 3 tables.)

Ethical guidelines of the 4 major professional associations representing counselors and psychotherapists are reviewed. To help clarify thinking about writing up clinical cases, 3 kinds of cases are described. The author concludes that the current guidelines for clinician authors in writing about clients for publication or presentation are contradictory and conflicting. The use of composite clinical case material is discussed as having a number of advantages over disguise or consent when writing about clients. Presented are guidelines for developing composite clinical cases and an example of how to use them effectively. (Contains 1 table.)

Today, the decision to prepare clinical case material for publication is a decision that cannot be taken lightly. The decision involves reviewing ethical considerations and choosing among various options to safeguard client privacy. Such options include seeking the client's permission, disguising case material, and developing composite case material. These considerations are discussed and options are described along with guidelines and a case example illustrating these points. (Contains 1 table.)

The author discusses her experiences seeking consent from 16 clients to use clinical material for publication. Sharing case examples from her practice, she elucidates her process with clients and focuses on the beneficial and detrimental effects on the therapeutic relationship. Seeking consent raises issues of confidentiality and stimulates wide-ranging, layered, and linked emotions and meanings for clients, including feelings of closeness, envy, and shame. If the counselor actively employs this process as a therapeutic tool with openness to unexpected meanings, it may advance the therapeutic conversation and developmental possibilities. When there is a negative effect on the client or the process, counselor's shame and guilt may be stimulated and consultation is recommended.

Since 2006 students have been paying top-up tuition fees and there has been much discussion in the sector about their impact on higher education institutions (HEIs). One of the main effects has been the frequently cited notion of the student as a fee-paying customer, seeking greater value for money not only for their fees but also for their overall student experience. This article assesses the impact of top-up tuition fees on HEIs from the perspective of a growing consumer culture in the sector and the response of HEIs to managing students' expectations.

This study examines the use of family education and support (FES) services within community-based mental health systems. Using data from the national evaluation of the Children's Mental Health Initiative (CMHI), 2,853 caregivers and their children ages 6 to 18 years from 39 communities participated in this study. The findings indicated that during the first 6 months of entry into services, one third of families received FES services, and the clinical characteristics of children whose families received FES services were found to be more severe at intake into services with significantly higher internalizing and externalizing problems and significantly lower strengths than those families who did not. Similarly, caregivers who received FES services entered services experiencing more strain. The findings have implications for the impact of FES services on children. (Contains 5 tables and 1 figure.)

While research regarding the effectiveness of the wraparound process is steadily mounting, little is known about how this service delivery model works and for whom. Using data gathered on 176 youth who participated in the wraparound process, the authors examine client and service factors associated with outcomes. Bivariate logistic regression analyses were conducted to determine the likelihood of treatment success based on select child and service characteristics. Results reveal that youth who exhibited lower levels of impairment at service entry were most successful in transitioning to and preserving a home placement, while those who possessed higher numbers of collateral supports were more likely to attain treatment goals. Findings also underscore the value of a planning process that promotes youth and family involvement in community activities. High adherence to this element of practice was found to predict both goal attainment and youth success in transitioning to a home setting. Implications for the implementation of the wraparound process with youth who are in residential care or at risk of out-of-home placement are discussed. (Contains 3 tables.)

Even though literature indicates that particular cultural groups receive more severe diagnoses at disproportionate rates, there has been minimal research that addresses how culture interfaces specifically with clinical decision making. This mixed methodological study of 41 counselors indicated that cultural characteristics of both counselors and clients--including the degree of match between these characteristics--affect attention to cultural issues in clinical decision making. In addition, there was a significant relationship between participant cultural bias and perceived level of client functioning.

Theory in career development counselling provides a map that counsellors can use to understand and structure the career counselling process. It also provides a means to communicate this understanding and structuring to their clients as part of the counselling intervention. The chaos theory of careers draws attention to the complexity, changeability and connectedness of components of career development. A framework for career counselling derived from the chaos theory of careers is outlined in terms of three factors: reviewing and reframing client expectations; exploring and engaging career development issues; encouraging and empowering career counselling outcomes for finding and constructing a career in a chaotic world. It is suggested that the chaos theory of careers offers a comprehensive theoretical conceptualisation that is able both to incorporate existing counselling practice and to suggest new counselling dimensions that could be incorporated into contemporary career practitioners' work.

Background: Because of the problems measuring subjective well-being in people with severe and profound intellectual disabilities, there are no studies to date which explore the factors contributing to the subjective well-being in these groups. We wanted to explore the client and service characteristics contributing to the subjective well-being of persons with severe and profound intellectual disabilities, as measured by the MIPQ (Ross & Oliver, 2003). Materials and methods: The MIPQ was completed for 360 persons with severe or profound intellectual disabilities by a member of the direct support staff. They also provided us with information on client, service and informant characteristics. Results: We found that the subjective well-being of persons with profound intellectual disabilities was lower than the subjective well-being of people with mild, moderate or severe intellectual disabilities or people without disabilities. Client and informant characteristics but no service characteristics were found to have an influence on the subjective well-being of people with severe and profound intellectual disabilities. Conclusion: As it is important for policy making to identify residence service and staff factors related to subjective well-being of persons with severe and profound intellectual disabilities, further research should try to identify these factors, taking in account the client characteristics that are found to be related to subjective well-being in this study. (Contains 4 tables.)

Career counselors are challenged to consider the cultural validity of the theories and models that guide their practice. The cultural formulation approach is proposed as an organizing framework for career counselors to consider cultural influences on their clients' career issues, related interventions, and the working alliance. The discussion illustrates the application of cultural formulation for career counseling with international students. A case study details common transition issues faced by international students, while exploring unique aspects of cultural identity. The case study illustrates how the cultural-formulation approach may be strengthened by incorporating a relational theoretical orientation as seen through a feminist lens to examine a client's multiple identities, such as the intersections of gender, ethnicity, and social class. (Contains 1 note.)

In this article, the authors present two hypothetical cases, one of a Mexican American female college student and one of a Mexican immigrant adult male, and apply a culturally sensitive approach to career assessment and career counseling with each of these clients. Drawing from Leong, Hardin, and Gupta's cultural formulation approach (CFA) to career counseling, the authors conceptualize the cases and provide a plan for working with these clients that takes into account the individual's career development and identity formation within the context of the Latina/o culture. Cultural dynamics in the career counseling relationship are addressed, and career counseling interventions that highlight the client's identity in the contexts of culture and extended family are provided for career counselors.

The authors investigated barriers to exercise and facilitators that enable midlife women to engage in an active lifestyle. Findings provide counselors with insight into the meanings that women ascribe to physical activity so they can better assist clients in making choices that enhance their overall health and wellness.

Most everyday child and adolescent psychotherapy does not follow manuals that document the procedures. Consequently, usual clinical care has remained poorly understood and rarely studied. The Therapy Process Observational Coding System for Child Psychotherapy-Strategies scale (TPOCS-S) is an observational measure of youth psychotherapy procedures designed to support the study of usual clinical care by providing a means of characterizing it. Coders independently rated usual care therapy sessions conducted with 43 children (aged 8-15 years) diagnosed with anxiety and depressive disorders. The TPOCS-S showed good interrater reliability, its 5 subscales (e.g., Behavioral, Cognitive, Psychodynamic, Client-Centered, Family) showed good internal consistency, and analyses supported TPOCS-S validity. (Contains 3 tables, 1 figure and 2 footnotes.)

This study uses a work stress theoretical framework to examine the effects of direct and indirect client violence on a randomly selected national sample of MSW and BSW social work students from the National Association of Social Workers (N=595). Client violence variables were analyzed in relationship to fear of future violence and occupational commitment. When students experienced every type of client violence except direct physical assault, they had significantly increased fears of future client violence. Students with increased fear of future violence had significantly increased normative and continuance occupational commitment. Students had exceptionally high affective occupational commitment, regardless of experiences with client violence. Implications for social work programs, field agencies, field educators, and social work students are discussed. (Contains 3 tables.)